Journal of Healthcare Management最新文献

{"title":"Organizational Resilience in Healthcare: A Scoping Review.","authors":"Hannah C Ratliff, Kathryn A Lee, Mara Buchbinder, Lesly A Kelly, Olga Yakusheva, Deena Kelly Costa","doi":"10.1097/JHM-D-24-00084","DOIUrl":"10.1097/JHM-D-24-00084","url":null,"abstract":"<p><strong>Goal: </strong>Healthcare organizations have always faced challenges, yet the past decade has been particularly difficult due to workforce shortages, the COVID-19 pandemic, and economic demands, all of which can impact quality of care. While some healthcare organizations have demonstrated the ability to adapt to such stressors-which has been termed \"organizational resilience\"-others have not. Most of the research on resilience in healthcare has been on individual clinicians; less is known about how extra-individual groups such as teams, units, and systems develop resilience. Understanding what organizational resilience is, how to measure it, and how healthcare organizations can develop it is essential to responding effectively to future acute and chronic stressors in the healthcare industry. The purpose of this scoping review is to synthesize how organizational resilience is defined and measured in the current healthcare literature and to inform future interventions to improve organizational resilience.</p><p><strong>Methods: </strong>We searched PubMed and Scopus databases for articles mentioning organizational resilience in healthcare. Eligible sources were those published in English through December 2023 in any format, and that described or measured organizational resilience in healthcare. Titles and abstracts were screened, and information was extracted from eligible articles.</p><p><strong>Principal findings: </strong>We screened 243 articles and included 97 in our review. Across these studies, organizational resilience was described as a healthcare system's ability to continue functioning and meet its objectives when exposed to stressful stimuli. Reactive and proactive strategies, as well as reflection, were identified as key components of organizational resilience. Four measures of organizational resilience were developed for use in healthcare, but only two have been validated.</p><p><strong>Practical applications: </strong>Future studies should focus on validating and comparing existing measures of organizational resilience and using them to investigate how organizational resilience may impact quality of care and clinician well-being, allowing the field to move beyond the focus on individual clinician resilience.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 3","pages":"165-188"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Discontinuity to Transformation: Drucker's Wisdom for Navigating Today's Healthcare Environment.","authors":"","doi":"10.1097/JHM-D-25-00072","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00072","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 3","pages":"149-153"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting Future Demands of Acute Care Through the Home Hospital Care Model.","authors":"Anne Klibanski","doi":"10.1097/JHM-D-25-00073","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00073","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 3","pages":"159-164"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Perspectives: Medical Social Workers' Early Insights on Health-Related Social Needs Screening and Follow-up.","authors":"Tess V DeVos, Emily Thatcher, Garrett Getz, Shannon E Nicks, Cynthia J Sieck","doi":"10.1097/JHM-D-24-00039","DOIUrl":"https://doi.org/10.1097/JHM-D-24-00039","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Goal: &lt;/strong&gt;As the impact of social determinants of health on patients' health status has received greater focus, and in light of national changes in requirements for hospitals to assess and address health-related social needs (HRSN), healthcare organizations are designing and implementing formal screening and follow-up processes for HRSN. While healthcare organizations are gaining more experience with both HRSN screening and subsequent resource provisions, engaging staff who implement screening and follow-up is key to the development of sustainable and informed processes. This study sought to understand the perspectives of medical social work regarding HRSN screening and follow-up in order to help shape the design and implementation of new screening and follow-up processes. Medical social workers (MedSWs) were identified because of their position as the staff members most likely to address, identify, and follow up on HRSN. Therefore, they have useful insights into the context in which these activities take place.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Interviews were conducted at an urban pediatric hospital in the Midwest. Eighteen MedSWs from various inpatient, outpatient, and mixed-setting departments were interviewed. All of this institution's medical social workers were invited to participate in the interviews, which were held individually or in groups based on participant preference. A semi-structured interview guide was developed, which addressed social worker background, clinic flow, current process for social needs screening and follow-up (formal or informal), and potential barriers to and facilitators of screening implementation. Interviews were recorded with participant consent and transcribed verbatim. The research team utilized a consensus coding approach to identify common themes and interpret results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Principal findings: &lt;/strong&gt;Four main themes were identified from these interviews. The first described the benefits of a standardized screening process in reducing bias and more accurately identifying needs. A second theme focused on the importance of coordination and collaboration among other members of the hospital system in addressing these needs. The third theme reflected concerns raised by participants regarding their capacity for immediate follow-up with patient families. Finally, perspectives on follow-up were shared about the tailoring of resources to specific patient needs, the capacity for addressing identified needs in a timely manner, and the trusted resources that MedSWs rely on when addressing needs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical applications: &lt;/strong&gt;Since these interviews were conducted, their findings have been used to contribute to the process of expanding social needs screening in this hospital. Recent changes, including the option for patients to select the method of follow-up used after a positive screening, were driven by the findings of this study. Future research may expand to other members of","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 3","pages":"205-219"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Information Sharing in Using Healthcare Information Technology: A Systematic Review.","authors":"Adelina Gnanlet, Min Choi","doi":"10.1097/JHM-D-24-00155","DOIUrl":"10.1097/JHM-D-24-00155","url":null,"abstract":"<p><strong>Goal: </strong>The primary goal of this systematic review is to assess the impact of healthcare information technology (HIT) applications on information sharing within and between healthcare organizations (HCOs) and their associated performance outcomes. This study is motivated by the significant growth in electronic health record adoption and other advanced technologies spurred by the Health Information Technology for Economic and Clinical Health Act of 2009. Despite this growth, there remains a gap in understanding where HIT adds value and how it affects various performance outcomes, particularly through information sharing in the healthcare sector.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-P 2020) methodology, this review focuses on empirical studies that examine the use and adoption of HIT in healthcare settings. The inclusion criteria targeted studies evaluating the impact of information sharing within or among HCOs through the use of HIT. The 66 papers that met our criteria were analyzed using Porter's value chain framework, which examines both intraorganizational and interorganizational activities to understand where value is created.</p><p><strong>Principal findings: </strong>The review reveals that HIT applications primarily enhance internal operations within HCOs, with 55% of the studies focusing on this aspect. In contrast, information sharing across multiple HCOs remains limited, with only 14% of the studies addressing this area. While quality improvement and cost reduction are the most frequently mentioned expected outcomes, surprisingly, productivity emerges as the most studied outcome variable, present in 33% of the articles. Most studies were conducted in the United States (67%), and physicians were the most frequently studied users of HIT, followed by nurses and other designated staff.</p><p><strong>Practical applications: </strong>The findings highlight the need for broader connectivity across the healthcare ecosystem. While private networks like Epic Cosmos and CommonWell facilitate data exchange, they remain confined within specific electronic health record systems, creating silos. The Trusted Exchange Framework and Common Agreement offers a more comprehensive approach, promoting universal and scalable information sharing across all stakeholders. To realize this potential, healthcare leaders must actively pursue the Trusted Exchange Framework and Common Agreement integration, standardize performance metrics, and foster collaboration to enhance patient care and operational efficiency.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 2","pages":"108-125"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kimberly Enard, PhD, FACHE, Associate Professor in the College for Public Health and Social Justice and MHA Program Director at Saint Louis University.","authors":"","doi":"10.1097/JHM-D-25-00011","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00011","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 2","pages":"82-86"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Performance of Hospital Telehealth Adopters, Nonadopters, and Switchers: A Rural-Urban Comparison.","authors":"Saleema A Karim, Cari A Bogulski, J Mick Tilford, Corey J Hayes, Hari Eswaran","doi":"10.1097/JHM-D-24-00026","DOIUrl":"10.1097/JHM-D-24-00026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Goals: &lt;/strong&gt;The adoption of telehealth in healthcare delivery has transformed patient treatment options. Urban and rural hospitals are increasingly using telehealth to reach more patients, improve patient engagement, and increase healthcare quality. Hospitals experience the operational benefits of adopting telehealth through improving clinical workflow, increasing efficiency, and improving patient satisfaction. These benefits may have financial implications through increases in patient volume and revenue, and reductions in provider overhead and costs. The overall effect of telehealth adoption on hospital financial performance is currently unknown. This study examines the association of telehealth adoption with the financial performance of rural and urban hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study uses retrospective data to examine the differences between urban and rural hospitals and community characteristics, profitability, and telehealth adoption from 2009 to 2019 in the United States. Data were obtained from the American Hospital Association Annual Survey and the Information Technology Supplement, the Centers for Medicare & Medicaid Services Healthcare Cost Report Information Systems, and the Area Health Resource File. Telehealth adoption status was determined using the American Hospital Association Annual Survey and the Information Technology Supplement Survey. Hospitals were classified into three categories, according to telehealth adoption status: (1) telehealth persistent nonadopters, (2) telehealth persistent adopters, and (3) telehealth switchers. Hospital financial performance was measured using operating margin and total margin. Descriptive statistics were used to evaluate the variation between the three categories of telehealth adoption status and hospital characteristics, hospital financial performance, and community characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Principal findings: &lt;/strong&gt;The study sample of 1,530 hospitals consisted of 56% rural hospitals and 44% urban hospitals. The results reveal disparities in financial performance between rural and urban hospitals. From 2009 to 2019, both rural and urban hospitals, identified as telehealth persistent adopters, exhibited higher operating and total margins compared to telehealth persistent nonadopter hospitals. Hospitals that transitioned from telehealth nonadopters to telehealth adopters, started with operating and total margins that closely aligned with telehealth persistent nonadopters. However, as hospitals adopted telehealth, both operating and total margins followed closely to telehealth persistent adopters. The results indicate that while hospital financial performance is associated with telehealth adoption, inferring causation is beyond the scope of these results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical applications: &lt;/strong&gt;The telehealth adoption status has unveiled noticeable patterns in hospital financial performance. In both rural and urban settings, hospitals persisten","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 2","pages":"93-107"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning Federal Grant Review Processes with Academic Standards: A Call for Reform.","authors":"","doi":"10.1097/JHM-D-25-00013","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00013","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 2","pages":"75-81"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Artificial Intelligence to Reduce Neuroscience ICU Length of Stay.","authors":"Kiran Kittur, Keith Dombrowski, Kevin Salomon, Jennifer Glover, Laura Roy, Tracey Lund, Clint Chiodo, Karen Fugate, Anish Patel","doi":"10.1097/JHM-D-23-00252","DOIUrl":"10.1097/JHM-D-23-00252","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Goal: &lt;/strong&gt;Efficient patient flow is critical at Tampa General Hospital (TGH), a large academic tertiary care center and safety net hospital with more than 50,000 discharges and 30,000 surgical procedures per year. TGH collaborated with GE HealthCare Command Center to build a command center (called CareComm) with real-time artificial intelligence (AI) applications, known as tiles, to dynamically streamline patient care operations and throughput. To facilitate patient flow for our neuroscience service line, we partnered with the GE HealthCare Command Center team to configure a Downgrade Readiness Tile (DRT) to expedite patient transfers out of the neuroscience intensive care unit (NSICU) and reduce their length of stay (LOS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;As part of an integrated NSICU performance improvement project, our LOS reduction workgroup identified the admission/discharge and transfer process as key metrics. Based on a 90%-plus average capacity, early identification of patients eligible for a downgrade to lower acuity units is critical to maintain flow from the operating rooms and emergency department. Our group identified clinical factors consistent with downgrade readiness as well as barriers preventing transition to the next phase of care. Configuration of an AI-powered model was identified as a mechanism to drive earlier downgrade and reduce LOS in the NSICU. A multidisciplinary ICU LOS reduction steering committee met to determine the criteria, design, and implementation of the AI-powered DRT. As opposed to identifying traditional clinical factors associated with stability for transfer, our working group asked, \"What are clinical barriers preventing downgrade?\" We identified more than 76 clinical elements from the electronic medical records that are programmed and displayed in real-time with a desired accuracy of over 95%. If no criteria are present, and no bed is requested or assigned, the DRT will report potential readiness for transfer. If three or more criteria are present, the DRT will suggest that the patient is not eligible for transfer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Principal findings: &lt;/strong&gt;The DRT was implemented in January 2022 and is used during multidisciplinary rounds (MDRs) and displayed on monitors positioned throughout the NSICU. During MDRs, the bedside nurses present each patient's key information in a standardized manner, after which the DRT is used to recommend or oppose patient transfer. Six months postimplementation period of the DRT and MDRs, the NSICU has seen a 7% or roughly eight-hour reduction in the ICU length of stay (4.15-3.88 days) with a more than three-hour earlier placement of a transfer order. Unplanned returns to the ICU (or bouncebacks) have remained low with no change in the preimplementation rate of 3% within 24 hours. As a result of this success, DRTs are being implemented in the medical ICUs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical applications: &lt;/strong&gt;This work is uniquely innovative as it shows AI can","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 2","pages":"126-136"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve Considerations for the Future of Healthcare.","authors":"Robert W Allen","doi":"10.1097/JHM-D-25-00012","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00012","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 2","pages":"87-92"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}